[Recommendations for the perioperative use of dipyrone : Expert recommendation of the working group on acute pain of the German Pain Society, the scientific working group on pain medicine of the German Society for Anesthesiology and Intensive Care Medicine and the surgical working group on acute pain of the German Society for Surgery with participation of representatives of the Drug Commission of the German Medical Association].

Stamer, Ulrike M; Stammschulte, T; Erlenwein, J; Koppert, W; Freys, S; Meißner, W; Ahrens, P; Brede, E-M; Lindig, M; Dusch, M; Heitfeld, S; Hoffmann, E; Lux, E A; Müller, E; Pauli-Magnus, D; Pogatzki-Zahn, E; Quaisser-Kimpfbeck, C; Ringeler, U; Rittner, H; Ulma, J; ... (2019). [Recommendations for the perioperative use of dipyrone : Expert recommendation of the working group on acute pain of the German Pain Society, the scientific working group on pain medicine of the German Society for Anesthesiology and Intensive Care Medicine and the surgical working group on acute pain of the German Society for Surgery with participation of representatives of the Drug Commission of the German Medical Association]. Der Anaesthesist, 68(8), pp. 520-529. Springer-Verlag 10.1007/s00101-019-0622-y

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BACKGROUND Dipyrone (metamizole) is widely used for perioperative pain management in countries where it is marketed; however, uncertainty exists concerning the safe use of this drug, specifically considering the rare adverse event of an agranulocytosis. METHODS As evidence from published studies was lacking, an expert panel developed recommendations for the perioperative use of dipyrone. After a formal, structured consensus process, the recommendations were approved by the involved medical societies. RESULTS The panel agreed that blood cell counts shall not be standard for short-term perioperative use in patients unless they are at risk for neutropenia. The medical staff shall be aware of the symptoms and course of action when agranulocytosis is suspected. Patients shall be informed about the risks and benefits of dipyrone and about potential alternatives. The expert group concluded that dipyrone has a relatively positive risk-benefit ratio compared to other nonopioid analgesics. The group strongly recommended educating patients about the symptoms of agranulocytosis if they have received dipyrone over several days and/or treatment is to be continued after discharge, because agranulocytosis can occur several days after discontinuation of metamizole. Further recommendations refer to the information of the physician taking over the patient's care after discharge and the avoidance of re-exposure in patients having previously suffered from dipyrone-induced agranulocytosis. CONCLUSION The group's recommendations shall be communicated in order to raise medical staff's and patients' awareness of the appropriate use of dipyrone in the perioperative period.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy

UniBE Contributor:

Stamer, Ulrike

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1432-055X

Publisher:

Springer-Verlag

Language:

German

Submitter:

Jeannie Wurz

Date Deposited:

02 Sep 2019 08:45

Last Modified:

02 Sep 2019 08:45

Publisher DOI:

10.1007/s00101-019-0622-y

PubMed ID:

31396674

Additional Information:

Published simultaneously in 5 journals

Uncontrolled Keywords:

Blood cell count Dipyrone (metamizole), safety Patient education Perioperative care Risk factors

BORIS DOI:

10.7892/boris.132810

URI:

https://boris.unibe.ch/id/eprint/132810

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